The efficacy of analgesics in controlling orthodontic pain: a systematic review and meta-analysis

Abstract

Background Patients who had gone through orthodontic treatment experienced pain and discomfort which could be the highest-ranking reason for treatment disturbance or early termination. Thus, this review aimed to assess the efficacy of analgesics on the relief of pain in orthodontic treatment. Methods A computerized literature search was conducted in the databases of EMBASE (via OVID, 1974 to 2019 Week 50), MEDLINE (via OVID, 1946 to Dec 2019), the Cochrane Central Register of Controlled Trials (CENTRAL) (December 2019). The Cochrane Collaboration’s Review Manager 5.3 software was applied in the present study. And methodological quality was evaluated by the Cochrane Risk of Bias Tool. Results We identified twelve publications including 587 patients in 19 randomized controlled trials. The results showed that the mean difference of naproxen in visual analogue scale (VAS) were − 1.45 (95% CI -2.72, − 0.19; P = .02), − 2.11 (95% CI -3.96, − 0.26; P = .03) and − 1.90 (95% CI -3.33, − 0.47; P = .009) in 2 h, 6 h and 24 h respectively. As for ibuprofen, the standard mean differences were − 1.10 (95% CI -1.49, − 0.71), − 1.63(95% CI -2.32, − 0.95) and − 1.34 (95% CI -2.12, − 0.55) at 2 h, 6 h, and 24 h, with the overall P values all < 0.001. The mean difference of acetaminophen is − 0.68, − 1.34, − 1.91 at three time points and the overall P values all < 0.01. Conclusions This meta-analysis suggests that the use of analgesics is effective for patients in controlling orthodontic pain. Ibuprofen and naproxen are both of stable analgesic effects which could peak at 6 h, while the analgesic effect of acetaminophen increases steadily from 2 h through 24 h. Compared with ibuprofen and acetaminophen, naproxen shows a stronger analgesic effect either at 2 h or 6 h, and its effect lasts to 24 h.

Chewing gum as a non-pharmacological alternative for orthodontic pain relief: A randomized clinical trial using an intention-to-treat analysis

“…Medical treatment, especially using nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen, is considered the most successful modality for reducing orthodontic pain. 1 , 2 However, several reports have suggested non-pharmacological methods for orthodontic pain relief, including low-level laser therapy 3 , 4 and masticatory stimulation of the periodontal ligament. 5 These alternatives also help overcome the side effects of NSAIDs and acetaminophen, such as stomach problems, allergic reactions, increased blood pressure, and liver toxicity.…”

Management of maxillary impacted canines: A prospective study of orthodontists' preferences

“…Many studies have explored the efficacy of different analgesics on reducing pain in orthodontic treatment mainly during insertion of orthodontic separators or archwire placement. Naproxen and ibuprofen provide stable analgesic effect that could peak at 6 h. Acetaminophen has an analgesic effect that rises steadily from 2 through 24 h. In comparison to acetaminophen and ibuprofen, Naproxen provides more potent analgesic effect which lasts to 24 h ( Cheng et al, 2020 ). No studies have investigated the effect of different pain killers on the relief of pain associated with surgical exposure of MICs.…”

Skausmas Ir Diskomfortas Ortodontinio Gydymo Breketų Sistema Metu

“…Prostaglandinai dalyvauja kaulo rezorbcijoje, todėl jų slopinimas gali neigiamai paveikti dantų judėjimo greitį ar sukelti dantų šaknų rezorbciją [14,17]. Jei pacientas sveikas, analgetikai pašalinami iš organizmo dar prieš prasidedant dantų judėjimui, todėl gydymo pradžioje NVNU pavartojus trumpą laiką ir mažomis dozėmis, dantų judėjimo greitis nebus paveikiamas [4,18].…”